A Hospital’s Tale of Bones, Bunkers and Bombs

It is easy to walk past the stretch of orange construction fencing outside Barzilai Medical Center in the coastal city of Ashkelon without batting an eyelid. But the site marks the epicenter of a saga of politics, war and religion that could destabilize the Israeli government.

Behind this fencing lies an ancient cemetery, unwittingly discovered in 2008 while builders were preparing the ground for a new $120 million underground wing, home to a new emergency room and a rocket-proof bunker. Ultra-Orthodox activists mounted pressure for the project to be abandoned so that the bones would not be disturbed, and the Israel Antiquities Authority put the project on hold indefinitely.

The Antiquities Authority believes that the bones are not Jewish, but Haredi leaders insist that they are. Israel’s two chief rabbis ruled in January 2009 that whatever the religion of the deceased, the bones may be moved as the hospital’s objective is to save lives. But prominent Haredi rabbis, including Yosef Shalom Elyashiv, wrote that the ruling constituted a “distortion” and an “uprooting of Torah.” The United Torah Judaism party (UTJ), the ultra-Orthodox party that subsequently came to control the Health Ministry, took up the battle to move the new wing — not the bones.

Now, following a Cabinet decision demanding that the hospital abandon the site altogether and start construction on a different plot farther away, and a subsequent reversal of that decision April 12 that could cause UTJ to leave the governing coalition, construction is set to resume — once the bones are reburied.

But all is not well at Barzilai. It is the hospital that serves Israel’s Gaza-envelope communities, including Sderot, and is just 7 miles from Gaza and within easy reach of rockets. According to the original plans, the hospital’s emergency team should be moving into the new wing’s large rocket-proof emergency room any day now. But as the saga has left it two years behind schedule, the emergency facility will remain a tiny, non-secure facility until at least 2012.

“I can’t provide the basic health services that the population needs on a normal day not during war,” Barzilai’s deputy CEO and medical director, Ron Lobel, said. “During war, my fear is that two Qassams [rockets] or Grads [a type of Katyusha rocket] will fall on the unprotected hospital, on the emergency room or the operating theaters, and this will completely paralyze the only hospital in the area.”

In the staff dining room at Barzilai on the day of Benjamin Netanyahu’s decision not to relocate the new wing, doctors and nurses were talking to each other over plates of chicken and rice. But during the Gaza operation, the buffets were swapped for beds and this dining room became an emergency room. This is the drill whenever there is high demand for an emergency room, explaining why there are oxygen sockets next to tables.

Barzilai’s current emergency room has just 20 beds, but it receives 100,000 visitors a year — an average of almost 275 a day. The average stay is the shortest of any emergency room in the country — 60 to 90 minutes.

On occasion, a single rocket attack has wreaked havoc. On September 11, 2007 — “our September 11” as Lobel calls it — a Qassam rocket injured 67 soldiers. “The first patient arrived at the emergency room saying that a mass-casualty event had happened,” and the hospital then needed to set up ad-hoc emergency stations.

Lobel fears that there will be a scenario like the Gaza operation, but worse — in which the wounded from Gaza-envelope communities are arriving, as are Israeli soldiers and Palestinians from the battlefield, and rockets are raining close to the hospital.

The delay of the new wing has ramifications across the hospital. During the Gaza campaign, doctors sent home or transferred to other medical centers 80% of patients to keep them safe from rockets. The new wing will have an underground bunker with room for 300 patients. This too was due to be ready by this spring, but following the delay will take until 2012, at the earliest.

That means numerous departments are bursting at their seams. During a recent visit to the 38-bed capacity department in one internal medicine ward at the hospital, there were 57 beds, including some in the corridor. Government funding for doctors is allocated according to the number of beds officially in the hospital, not how many patients are actually being treated. As it stands, the ward’s medical director, Doron Zamir, continually rushes to complete his round of half the patients in the allotted time of three hours. “Try to think: That’s six minutes for a patient, which is nowhere near enough,” he said.

As Barzilai prepares for another two years in these conditions, UTJ party leaders are considering how it will get over this high-profile political defeat. It was under intense pressure from religious hardliners to stand firm on the issue. Media reports have speculated that the Barzilai project could have electoral benefits in nearby Ashdod, where there is a large Haredi population, as it could increase the chances of a hospital opening there.

Yerach Tucker, a spokesman UTJ lawmaker Moshe Gafni, said that “there will be a [party] meeting and they will bring the question to the rabbis about how to act.” Gafni is opposed to leaving the coalition, but, as the party is an alliance of different groups beholden to different rabbis, it is “not definite” that his viewpoint will be supported.